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Therapeutic efficiency of rhenium-188-HEDP in human prostate cancer skeletal metastases.

Liepe K, Kropp J, Runge R, Kotzerke J - Br. J. Cancer (2003)

Bottom Line: Mean platelet count decreased from (286+/-75)*10(3) microl(-1) to (215+/-92)*10(3) microl(-1), and mean leucocyte count from (7.7+/-1.5)*10(3) microl(-1) to (6.0+/-1.9)*10(3) microl(-1) in the second to the fourth week after therapy.The maximal differences between the values of platelets and leucocytes before and after therapy were not statistically significant (P=0.021 and 0.094).In conclusion, (188)Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital Dresden, Fetscherstr 74, 01307 Dresden, Germany. liepe@rcs.urz.tu-dresden.de

ABSTRACT
Rhenium-188-HEDP ((188)Re-HEDP) is a new and attractive radiopharmaceutical for the treatment of metastatic bone pain. As a product of (188)W/(188)Re generator, it is convenient for clinical therapeutic use with a short physical half-life of 16.9 h and a maximal beta-energy of 2.1 MeV. We investigated the effect of (188)Re-HEDP on pain relief, analgesic intake and impairment of bone marrow function in 27 patients with bone metastases induced from prostate cancer. All patients were interviewed using a standardised set of questions before, and after therapy for 12 weeks. The patients were treated with 2700-3459 MBq of (188)Re-HEDP. Blood samples were taken weekly for 12 weeks, and a blood count was performed. Patients described an improvement on the Karnofsky performance scale from 74+/-7 to 85+/-9% 12 weeks after therapy (P=0.001). The pain score showed a maximum decrease from 44+/-18 to 27+/-20% in the third to the eight week after therapy (P=0.009). Seventy-six percent of the patients described a pain relief without increase of analgesic intake. Twenty percent of the patients could discontinue their analgesics and were pain free. Mean platelet count decreased from (286+/-75)*10(3) microl(-1) to (215+/-92)*10(3) microl(-1), and mean leucocyte count from (7.7+/-1.5)*10(3) microl(-1) to (6.0+/-1.9)*10(3) microl(-1) in the second to the fourth week after therapy. The maximal differences between the values of platelets and leucocytes before and after therapy were not statistically significant (P=0.021 and 0.094). In conclusion, (188)Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity.

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(A) Bone scan of a 71-year-old patient with bone metastases induced by prostate cancer one month before 188Re-HEDP therapy (bone scan index=45). The Karnofsky performance scale was 70% and the pain of the visual analogue scale=50%. (B) Bone scan of the same patient 6 months after therapy (bone scan index=17). The Karnofsky performance scale was 80% and the pain of the visual analogue scale=25%.
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fig5: (A) Bone scan of a 71-year-old patient with bone metastases induced by prostate cancer one month before 188Re-HEDP therapy (bone scan index=45). The Karnofsky performance scale was 70% and the pain of the visual analogue scale=50%. (B) Bone scan of the same patient 6 months after therapy (bone scan index=17). The Karnofsky performance scale was 80% and the pain of the visual analogue scale=25%.

Mentions: No patient showed a decrease in the bone metastases demonstrated on the 99mTc-HMDP bone scans before treatment when compared to the scans obtained 3 months post-treatment. The bone scan index (BSI) level (Blake et al, 1986) in the group of patients with no response to the 188Re-HEDP therapy was 54±19, in the group of patients with a good response 37±14 and in pain-free patients 36±5 (P=0.24). In three of the patients, there was a decrease of the number of bone metastases with a mean decrease of the BSI level from 33±18 before treatment to 19±11 within 1 year after 188Re-HEDP therapy. One of these showed an improvement of the BSI from 45 to 17 six months after therapy (Figure 5A, BFigure 5


Therapeutic efficiency of rhenium-188-HEDP in human prostate cancer skeletal metastases.

Liepe K, Kropp J, Runge R, Kotzerke J - Br. J. Cancer (2003)

(A) Bone scan of a 71-year-old patient with bone metastases induced by prostate cancer one month before 188Re-HEDP therapy (bone scan index=45). The Karnofsky performance scale was 70% and the pain of the visual analogue scale=50%. (B) Bone scan of the same patient 6 months after therapy (bone scan index=17). The Karnofsky performance scale was 80% and the pain of the visual analogue scale=25%.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2376909&req=5

fig5: (A) Bone scan of a 71-year-old patient with bone metastases induced by prostate cancer one month before 188Re-HEDP therapy (bone scan index=45). The Karnofsky performance scale was 70% and the pain of the visual analogue scale=50%. (B) Bone scan of the same patient 6 months after therapy (bone scan index=17). The Karnofsky performance scale was 80% and the pain of the visual analogue scale=25%.
Mentions: No patient showed a decrease in the bone metastases demonstrated on the 99mTc-HMDP bone scans before treatment when compared to the scans obtained 3 months post-treatment. The bone scan index (BSI) level (Blake et al, 1986) in the group of patients with no response to the 188Re-HEDP therapy was 54±19, in the group of patients with a good response 37±14 and in pain-free patients 36±5 (P=0.24). In three of the patients, there was a decrease of the number of bone metastases with a mean decrease of the BSI level from 33±18 before treatment to 19±11 within 1 year after 188Re-HEDP therapy. One of these showed an improvement of the BSI from 45 to 17 six months after therapy (Figure 5A, BFigure 5

Bottom Line: Mean platelet count decreased from (286+/-75)*10(3) microl(-1) to (215+/-92)*10(3) microl(-1), and mean leucocyte count from (7.7+/-1.5)*10(3) microl(-1) to (6.0+/-1.9)*10(3) microl(-1) in the second to the fourth week after therapy.The maximal differences between the values of platelets and leucocytes before and after therapy were not statistically significant (P=0.021 and 0.094).In conclusion, (188)Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital Dresden, Fetscherstr 74, 01307 Dresden, Germany. liepe@rcs.urz.tu-dresden.de

ABSTRACT
Rhenium-188-HEDP ((188)Re-HEDP) is a new and attractive radiopharmaceutical for the treatment of metastatic bone pain. As a product of (188)W/(188)Re generator, it is convenient for clinical therapeutic use with a short physical half-life of 16.9 h and a maximal beta-energy of 2.1 MeV. We investigated the effect of (188)Re-HEDP on pain relief, analgesic intake and impairment of bone marrow function in 27 patients with bone metastases induced from prostate cancer. All patients were interviewed using a standardised set of questions before, and after therapy for 12 weeks. The patients were treated with 2700-3459 MBq of (188)Re-HEDP. Blood samples were taken weekly for 12 weeks, and a blood count was performed. Patients described an improvement on the Karnofsky performance scale from 74+/-7 to 85+/-9% 12 weeks after therapy (P=0.001). The pain score showed a maximum decrease from 44+/-18 to 27+/-20% in the third to the eight week after therapy (P=0.009). Seventy-six percent of the patients described a pain relief without increase of analgesic intake. Twenty percent of the patients could discontinue their analgesics and were pain free. Mean platelet count decreased from (286+/-75)*10(3) microl(-1) to (215+/-92)*10(3) microl(-1), and mean leucocyte count from (7.7+/-1.5)*10(3) microl(-1) to (6.0+/-1.9)*10(3) microl(-1) in the second to the fourth week after therapy. The maximal differences between the values of platelets and leucocytes before and after therapy were not statistically significant (P=0.021 and 0.094). In conclusion, (188)Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity.

Show MeSH
Related in: MedlinePlus